58 Sedation and Analgesia for Incarcerated Inguinal Hernia in the Paediatric Emergency Department
Bibliographic record
Abstract
Ten percent of children with inguinal hernia will experience incarceration and a reduction procedure will be required. The procedure involves pain and discomfort in most cases. No recommendations on the level of sedation or analgesia for children exist. We conducted a formal mail survey among paediatric emergency physicians (131) and paediatric surgeons (45) in eight centers across Canada. The survey consisted of multiple choice questions to determine the use of sedation or analgesia for incarcerated hernia reduction and the length of the trials. Up to 3 surveys were sent. Data was entered into Microsoft Excel software and descriptive statistics were done with the SPSS program. A total of 118 (67%) of the physicians responded. Eighty four (71%) stated that they would perform the first reduction trial with no sedation or analgesia. If another trial was needed, 74 (62%) would have given sedation or analgesia, mostly through the intravenous route. Fentanyl and Midazolam were the most frequently prescribed medications. The first attempt at reduction would last 5±5 minutes (range 1–30); waiting between trials was suggested to be on average 14±10 minutes long (range 1–45) and the number of attempts the responders would carry out was on average 2±1 trials (range 0–3). Paediatric emergency physicians and paediatric surgeons do not use a unified protocol for reduction of incarcerated hernia in the paediatric emergency department and significant practice variation exists. Effort should be made to create and disseminate a protocol for sedation and/or analgesia during this urgent procedure.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".